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HomeMy WebLinkAboutMILE HI BLK 1 LT 1Mile - H*I Block 1 Lot 1 #050-201-02 Municipality of Anchorage Development Services Department Building Safety Division ' • ' ' Onsite Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page I of _3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. S L& 0 1 0 12-0 PID Number. 050 —a201— 0'L Nerne � Wastewater System: []New 0 Upgrade L�O.rp' /L$ A4 "" 2/8 Z7 Na' N; ABSORPTION FIELD Pna» Hueter of •:, O MSP Tran t D shall" Trndl O gadH Mw10 O QINr , Soil Rama Tdal Dean rrarll original Vale: LEGAL DESCRIPTION .Zrpome I 91atlt: Lot: IiWdvia Depen b PPe w= ftm agew Veda: Gravel do" beneath ppe: fle 5 FI. Lei 1 $ t; 1 ✓L r 1 c —14 1 0,5 Fl. Tomtshnx Rang•'. seelat FA added above aq M Vader, Length: h FI. / Ft. El New Upgrade GravM••de,: /t7 MmMrolNra: •" DH"nca penveanlMe: Ft. Well: Ft, Chas f ao (Pmale. A 9. CrY cased to: Taal abswV" rea P S a,k, c44 4 qD P V w l Fl. Ft F� order. ee Dnned SMtc water Lav*: Installer. one MHaosa: C �� i Ft 2A N Yro P n: CngHingleAboseGm C"ng TANK G FL Ft SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. other. To Septic Absorption Lift Holding PubliUPrivat M�a W. /7 %O c,Paulw /1,00 Gu. From Tank Field Station Tank Sewer line C— Llt r o Bd Matenal _ /I G-�t55 /'Fryte Num Qt c aM.Mla' wen too 110 17.0 Safees water 010 "10 "10 LIFT STATION Lot one �(� 7 0 —70 Gal /� •Poop al' lav« at 'Fong dr level K � Hpn seal« ererm '. Fo, d on PLO 4 o /� v In Curran Drain 1J I O N I O I t7 Perry Make 8 MOON M1 t C tr Elsaneal ha pAo/r��ed�rW. / Com' •% 1 Q" L e e /vt Gi Ren'e'w BENCH MARK / / /� /1 01e T{.ree4 af9�Yi1�FlCdY1G Louuon W D.tmWwn: / l b e'VlLr'G(,L C/4. �% O1.41� C'Y"N•S f �U it .f 61' Nwrrlad Ewvauon. tdo, O1C)Ft. Erigineei s Stamp , S/7/d / by: Dates: 1" .,........ V.. I 1 Inspections performed • 2nd - Development Services Department Approval < '•_, c=�'�� �' Date:%' 01 Reviewed and approved by:�• (lien. 1•JFD) _� .��aaaaaa�4,, N � i �,`Q'(,..... � •41.1 \ 49th . >} . i \ TOBB N SPURKLAND .; No. CE-2z2s•..tii \4444444�ESS1.♦••♦ t \ 4aaaaaa♦ � RS 0 �2j SO 75 100 125 150 I \ \ SCALE, 1' = 50 FT. t I` SWING TOTAL D TH AC 35 R \ 15X15 BC 254 \ e,1 t AD 52 FX TER SAND 1 It . D 80 62 SEPTR ROCK 0. lFf7 I COVER 3 A S \ \ 1 YIXE UN? ID 0 CH MA MILE HI A UE BENCH MARK: CONCRE7E PAD. ASSUMED ELEV. 100.00 R 109B£N SPURKLAND P.E. LOT 1 BLOCK 1 MILE-HI SID SEPTIC SYSTEM AS BUILT 203 W 15TH. AVENUEDATE: JUNE 14, 1001 ANCH. AY.. 99501 21827 MILE-HI AVE. 907 279-3916 CAROL G/fSE SHEET 2/3 GRID: NW58 PERMIT M SV0I0120 PID k 050-201-02 MH101012.DVG 4' MN17ER ASTM 3034 — I STANDARD BED NTS fOU1DDA110N aEAN OUT BLLEBOARO 1NSLCATMV INSTALLATION L EXCAVATE A 10' x 1a x Io' DEEP lar Fur BlXrar SYSTEM 2 PLACE A HINIMLN Or I' SAND LR GRAVEL FLIP LEMIAG CARS£ 1N 17C BI1rTLN Or TIC EXCAVATION CLNPACT AS REQUIRED 3 PLACE 4 SI[rTS Or 2' x B' x 2' DIRECT BLRIAL RIGID D=A1DN IN 7EP LT COWACTCD LEMW CaRSC TO PROTECT BOTMN IT FIBERGLASS TAAK TAKE EXTRA CARE 70 ASSOPE TH4r INSLEATMV CaVSf IS LEVEL IN ALL DIRECTIOIS I. BACKFILL ARO.ND TANG LP TO INVERT OF t' WI LETVT AND 1-1/I' ETFLLENT LPCS WITH FREE-FLOVING NSF . MATERIAL FREE IT LARGE STOLrS LR BaLDERS e lCNITOR TUBE .:.'' . .......... ... 6"'.. • , . 15' SAND/GRAVCL BACKfILI.•"'.'�S.;Ya 10 e 1-1/4' SCICDLLC 40 PVC V/ 1/0' hCCfS P 30' •',�. - --• .• - ' � TOP AND SOTWM b NOVITOR TUBE BENCH MARK: CONCRElC SUB. ASSUMED ELM 100.00 FT 0 TOSB£N SPURKCAND P.£. LOT 1 BLOCK 1 MILE—HI S/D SEPTIC SYSTEM SHEMATIC 203 W 15TH. AVENUE DA TE. JUNE 14, 2001 ANCH. AK. 99501 11827 MICE—H! AVE. __ --- --._ CAROL GIESE SHEET 3/3 GRID: NW58 I PERMIT # S"10120 PID q Oso -201-0 WIOI013BVG I SL OPE FINISNfD GRADE AVAY I 10f.J �, FROM IOP IN ALL DIRECTIONS 6' MIN 24' MAX /I-1/ PVC DIXMRX I' PVC MLENT to PPRIM4RY C/4WB£R CD AERAT9W CHAMBER SIO m 0 CLARIFIER ONS014RGC CHAMBER J 5 A I h �NGrTLH Dr TAW BLLEBOARO 1NSLCATMV INSTALLATION L EXCAVATE A 10' x 1a x Io' DEEP lar Fur BlXrar SYSTEM 2 PLACE A HINIMLN Or I' SAND LR GRAVEL FLIP LEMIAG CARS£ 1N 17C BI1rTLN Or TIC EXCAVATION CLNPACT AS REQUIRED 3 PLACE 4 SI[rTS Or 2' x B' x 2' DIRECT BLRIAL RIGID D=A1DN IN 7EP LT COWACTCD LEMW CaRSC TO PROTECT BOTMN IT FIBERGLASS TAAK TAKE EXTRA CARE 70 ASSOPE TH4r INSLEATMV CaVSf IS LEVEL IN ALL DIRECTIOIS I. BACKFILL ARO.ND TANG LP TO INVERT OF t' WI LETVT AND 1-1/I' ETFLLENT LPCS WITH FREE-FLOVING NSF . MATERIAL FREE IT LARGE STOLrS LR BaLDERS e lCNITOR TUBE .:.'' . .......... ... 6"'.. • , . 15' SAND/GRAVCL BACKfILI.•"'.'�S.;Ya 10 e 1-1/4' SCICDLLC 40 PVC V/ 1/0' hCCfS P 30' •',�. - --• .• - ' � TOP AND SOTWM b NOVITOR TUBE BENCH MARK: CONCRElC SUB. ASSUMED ELM 100.00 FT 0 TOSB£N SPURKCAND P.£. LOT 1 BLOCK 1 MILE—HI S/D SEPTIC SYSTEM SHEMATIC 203 W 15TH. AVENUE DA TE. JUNE 14, 2001 ANCH. AK. 99501 11827 MICE—H! AVE. __ --- --._ CAROL GIESE SHEET 3/3 GRID: NW58 I PERMIT # S"10120 PID q Oso -201-0 WIOI013BVG I f.A MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO10120 Legal Description:MILE HI BLK 1 LT 1 Date Issued: May 21, 2001 Expiration Date: May 21, 2002 Parcel ID: 050-201-02 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 021827 MILE HI AVE Owner Name: CAROL GIESE Lot Size: 47568 SO. FT. Owner Address: 21827 MILE HI AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577 - This permit is for the construction of: g Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (1 BAAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, seated, and heated to prevent freezing. Received By: Issued By: Date: .5'-a t — O / Date: -- 2 Z — 4Y Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 05b —— Permit Number SWC/41/20 Property owner(s) C� �n L C� 1 ESQ Day phone Mailing address (1) VS R _7 A 0 FIA &LE R)yLrR Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) G �_ % 13 Y 1 K t L1: 14-/ Legal description (Section, Township & Range) Lot Size47S'6� Acres q.Ft. THIS APPLICATION IS FOR: Sewer Only Sewer and Well ❑ Sewer Upgrade /%9L THIS PROPERTY CONTAINS: Number of Bedrooms 3 Well Only Water Storage Hot Tub ❑ Jacuzzi Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Marticipal Codes. (Signature of property owner or authorifid agent) Permit Fees: fl 3��// Waiver Fees: Date of Payment: /-2 / Date of Payment: Receipt Number: e2a�/ y� Receipt Number: (Rev. 12/00) PROPERTY OWNER AGREEMENT �. FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM c2m / This agreement, dated 499=, is made between the Municipality of Anchorage Department of Health #nd Human Services (DHHS) and the property owner(s) of. t -D i I This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, ind that any deficiencies have been repaired and that the system is functioning as designed. (Si ture) Claro l A. Giese - (Signature) (Printed Name) (Printed Name) -----------------------------.N:tarize Here ------------------------------------ State of i' On this lA daY of darn! ,Mese 7Je pe-sonally appeared before in , who is personally known whose identity I proved whose identi_v I proved to be the signer of the above document, to me on the basis of on the bath/affirmation of a credible witness and -hr/0acknowledged thatsh signed it. �r�_ Notary Public My commission expires /-A.t,­().7, 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 1 BLOCK I MILE -HI SID Carol Giese Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700I3ragaw Street Anchorage, Alaska 99519-6650 March 26, 2001 We arc submitting an application for the replacement of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholcs are also enclosed. The septic system design is based on the following : Ground Water observed at 6 ft. Use BioCycle with bed. Soil Rating. From Testhole 03/13/01 20 min/in - 2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15012 - 75 sq.ft. Total area required: 75 x 3 - 225 sgft Bottom Rock At I foot Rock Depth 0.5 feet Filter sand I foot SYSTEM CONFIGURATION STANDARD TRENCII TOTAL LENGTH 10 FT TOTAL WIDTH 22.5 FT TOTAL DEPTH 2 FT FILTER SAND I FT ROCK DEPTH 0.5 FT COVER 3 FT SEPTIC TANK BIOCYCLE The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. LOT 4 / LOT 5 <5> PRINCE DRIVE LOT �( TRACT B � v I � 1 DO GL AS D 04NI 1 I 50 0 50 100 150 2AD 250 3W SCALE, 1'= 100 FT. sj� i \�\ LOT 7 49th F ....... . T BEN SPURKLAND CJS•._ No. CE -2225 el TOBBEN SPURKLAND P.E.LOT 1 BLOCK 1 MILE - HI SID SEPTIC SYSTEM DESIGN 203 W 157H. AVENUEDATE.- MARCH 13, 2001 ANCH. AK. 99501 21827 MILE -H/ AVE. 907 179-3916 CAROL G/ESE SHEET.- 1/3 CR/D: NW58 PERMIT # SVOIOXXX PID # 050-201-02 MH101011.17VU Xf� = 49th �\ .i• ... ........................:...� r •......... �....4<.:.... 0�t TOHB N SPURKLAND � •�Cltl� o. CE -2223.• .1 AV \8�1�1nNt.��o����� 441, t ♦ RS 0 ,?5 50 75 L00 T25 ,50 \ \ \LE,1'=50 f7. SIANOARO BCD \ TOTAL D \ TOTAL OCPTN 1 fC£T fVER SANG T COOT SEWER ROCK 0.5 MET COVER 3 frrT \ mAll MILE HI AV A �� a1) Sys ..., TOBBEN SPURKLAND P.E. LOT 1 BLOCK I MILE—HI SID SEPTIC SYSTEM DESIGN 103 W 157H. AVENUE 21827 MILE—H/ AVE. DATE: MARCH 26, 2001 ANCH. AK. 99501 11 CAROL GI£SE I I SHEET: 1/3 GRID: NW58 a SWOIOXKK a MH101012.DWG 4'FKNITOR ASTM 3034 GRALC' W MAN BACK F2L I STANDARD BED NTS b Fau+DDallOv aEav aur _� 2I' MAX OMOMI 3' �1-1/ PVC D/StiTARGE J e - FNISHED GRADE AVAY T17P IN ALL DIRECrlLNS 3 1 4' PVC MI LUT (D PPRDARY CHAMBER m AERATION CHAMBER m CLARIRER G)DISCFARGE CHAMBER /BOTTOM Or TAMC \2' BLLEBOARD NSaATILN INSTALLATION 1. EXCAVATE A !0' x 10' x 10' DEEP Aar FOR BIXYCLE SYSTEM 2. PLACE A MINIMN X A' SAND UR GRAVEL FZR LEMIAG CDWX N THC BOTTOM Or THE EXCAVATION C@PAC' AS REWIREA 3 sr TO PROTECT BOTTOM DF FIBERGLASS TAW ANG TAKE EXTRA CAR£ATIT ASSURE THAT INSL ATAW LC RSt /SEVELIAG EVEL IN ALL DIRECTJLK l MAA m AL MWV L� STO T A LENT AND 1-1/I' ETFLLENT LDCS VITH FREE-FLOVTNG NSF 22.5' 1G4TTlAP 'uBC � SAND/GRAVEL BACXfD.L 17s �-1 , 1-1/�' SCEDU.0 10 PVC V/ 1/8' FILES L9 30, MNITDR WK h ?' yz fe,�*�s: To .en 5^v.lSund .�'.�•. Q s•. CS2225 :. OI TOBBEN SPURKLAND P.E. LOT 1 BLOCK 1 MILE -HI S/D SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE 21827 MILE -HI AVE. DATE: TODAY ANCH. AK. 99501 CAROL GIESE SHEET. 1/3 GRID: NO 907 179-3916 PERMIT B PID # WOIOI3DVG A 4P�E,OF ..AA:;S1C, r Municirality of Anchorage / Ft. • V DEPARTMENT OF -tEALTH 8 HUMAN SERVICES �- P. T Sen S,^vrkland 825 "L" Street. Anchorage, Alaska 99502-0650 ` �• ., CE -2225 SOILS LOG — PERCOLATION TEST PERFORMED FOR: iI CL re / 6-;,1 Se DATE PERFORMED: LEGAL DESCRIPTION: �ta £!K/r raa if —1:I SIP Township. Range. Section: (�� T j SLOPE SITE PLAN 6"A1,1104 I I I 1 —1 1 ..v 2 i 4- 6- 8- 9- 10 6 8 10 11 12 13 14 1s 16 17 18 19 12cTTow Or= Ill aI WAS GROUND WATER ENCOUNTERE07 S T WHAT r• P .�R //E r Auer 13 /p/ Date: tilt IF YES. A DEPTH? Depth to wale Monitoring? M=mmm 20 -{ 1- aI UPERCOLATION RATE iZ"= (mmutevrntS2) PERC HOLE DIAMETER TEST RUN BETWEEN � FT AND —_5-- FT DISCLAIMER- Grnundwater rDnditinns indirated are fnr the dates shown only. Past and future presence and/or depth of groundwater can not be predicted from ese 0 Se.Cya Ions. PERFORMED BY. / I I S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS DATE. DATE: 3 a 3 — (] 72-008 (Rev. 4185) 20 -{ 1- aI UPERCOLATION RATE iZ"= (mmutevrntS2) PERC HOLE DIAMETER TEST RUN BETWEEN � FT AND —_5-- FT DISCLAIMER- Grnundwater rDnditinns indirated are fnr the dates shown only. Past and future presence and/or depth of groundwater can not be predicted from ese 0 Se.Cya Ions. PERFORMED BY. / I I S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIC ELINES IN EFFECT ON THIS DATE. DATE: 3 a 3 — (] 72-008 (Rev. 4185) MAI ER ANCHORAGE AREA BOR6jGH Department of Environmental Quality i� ' 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ���✓" ��'x �. � MAILING ADDRESS�'A F1 j Y � 'P-JPHONE i LOCATION �� � �s'-/loll LEGAL DESCRIPTION 0, l Z Z Z' i SEPTIC TANK: NUMBER C'� DISTANCE OF FROM WELL MANUFACTUREFig\f4 MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 07c� GALLONS. SEEPAGE:"ony`t'n1r �y NUMBER OF PITS DIAMETER OR WIDTH! LENGTH—, DEPTHS-� LINING MATERIAL A -'_e_14_ CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION—, NEAREST LOT LINEt2 ABSORPTION AREA (WALL AREA) FT. ADDITIONAL ABSORPTION WELL:,y TYPE —CONSTRUCTION— 7�rJ� CONSTRUCTION DEPTH a DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: _ INSTALLED BY:— PIPE MATERIAL: LOT SLOPE: REMARKS: lo-Le�X Form No. EQ -031 REMARKS DIAGRAM OF SYSTEM 6 7�L APPROVEDk.,wf� G., L_xr S r fID;"3dqFvvc tQ; ',lea GREA'', R ANCHORAGE AREA BOR( GHL JJN6 • /0 DEPARTMENT OF ENVIRONMENTAL QUALITY - PERMi N 3330 "C" STREET ANCHORAGE, ALASKA 99503 / ' \ /f TELEPHON 274-4561 \ 4L AJ !`y zlnnv nzcy SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT �ry '' MAILING ADDRESS INSTALLATION LOCATION LEGAL DESCRIPTION L 7C2 INSTALLATION OF: SEPTIC TANK - SEEPAGE PI7 r TYPE AND SIZE OF FACILITY TO BE vvn FINANCED THROUGH f� ;O. 7E INST./:' L.LED SOIL TEST RESULTS / �! f / _ NOTE: TH11 COMPLETION DATE ANTICIPATED PHONE DRAIN FIELD OTHER PERMIT IS. NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD /y l SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT `1- DRAIN FIELD L� TO EAREST LOT/r E. W LL To EPTIC TANK SEEPAGE PIT DRAIN FIELD /(-�" / ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD-. SEPTIC TANK, SEEPAGE PIT 1. DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. r GRAVEL BACKFILL CONFORM TO BOROUGH,.REGULATIONS REGARDING INSTALLATION. J G.A.A.B. OR LICENSED DESIGNER SIZE ZTYPE PXnV C C '�� DIARAM OF SYSTEM / jj of -'r i f, yj - - - -- i Y` 3{ 7 � i i 1 I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBE SYS EM IS IN ACCORDANCE WITH SAID CODE. DATE '" APPLICANT'S SIGNATURE FORM NO. EQ -016 I r r Y u 32 7 7 0 Ef E GEOTECHNICAL & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Soils Et Foundations SOIL LOG Ear/ Ellis 688-2280 Land Development Performed for: Name:_ ��:� \ .F,�d�, ;��E, Tel. No. �SI� T 0 Mailing Address: max j��a� ,�;=`_7"vt Ncz q 01 Legal Description: �A �Lv, �, v Depth (feet) Soil Characteristics T 0 2. 3 5 6 7z � v Fe/ L, \ Vim'" g Q ' V 9 10 C(N ��,, ��,,J��i �T����✓ 11 \J , ; u 0,6/ 12 Arc`- i D' ' U•c� 4—s 5. ��rom Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit ✓ Drain Field Comments: HiQ S Lz- !-)�7 2f: Performed by: 1,� Date: -,T; MINIMUM DISTANCE BETWEEN A WELL fig -?L:' ANY i 1-4--E-I"1'E r�:F�.!t�G1'. ['7:_:F C' tsL... :_;'r'.`:� 100 FEET' FLIP:' A PRIVATE WELL OR 200 FEET FI_IE: A F'LIEILIC:: WELL. WELL LOGS ARE REQUIRED AND 1__T BE RETURNED TO THE: DEF AR ME N"I' WITHIN : _.0 DAY"3 OF THE: WELL COMPLETION. SPECIFICATIONS FiND CONSTRUCTION DIAGRAMS r" RE: AVAILABLE TO INSURE PROPER I NSTALL_I-i_E I or.j. F;?_ P''l I ...I... a v " F" 1 iL_ I C_ -e E= ®�� �°=° A..._B G''� �� s� s �- �"'� �,=_ F" F-0. A..._A rl I _'= _; 3 I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WIL..I_. INSTALL THE SYSTEM IN-I.:COPT.:+fiNC:E WITH '[*HE CODES. F'PLIC.-ANT CAMERON I'-. L1EC E.' _ _ � ___._.._.___DATE�"�� 1 j .. ....... r- _- L'EPAR I t fF_P.! E I LiE 1 1( T F I AP -Jr." f �. 2510 F.. iil;d:.R f.C:+. I P,II"!f'.If. PERMIT NO. APPL I CM -41" [;:f PffR I!•a L..L.11_F: 6 Ft;'; 616. LAL"'lI__i-. V". ':;,E.-{ LI_II:FITION MILE HIGH nVE. 'E. R. I._EGt1L i__1.. F:]_ MILE HIGH I::iH E S Trt i E' _ _. _ ._ MINIMUM DISTANCE BETWEEN A WELL fig -?L:' ANY i 1-4--E-I"1'E r�:F�.!t�G1'. ['7:_:F C' tsL... :_;'r'.`:� 100 FEET' FLIP:' A PRIVATE WELL OR 200 FEET FI_IE: A F'LIEILIC:: WELL. WELL LOGS ARE REQUIRED AND 1__T BE RETURNED TO THE: DEF AR ME N"I' WITHIN : _.0 DAY"3 OF THE: WELL COMPLETION. SPECIFICATIONS FiND CONSTRUCTION DIAGRAMS r" RE: AVAILABLE TO INSURE PROPER I NSTALL_I-i_E I or.j. F;?_ P''l I ...I... a v " F" 1 iL_ I C_ -e E= ®�� �°=° A..._B G''� �� s� s �- �"'� �,=_ F" F-0. A..._A rl I _'= _; 3 I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WIL..I_. INSTALL THE SYSTEM IN-I.:COPT.:+fiNC:E WITH '[*HE CODES. F'PLIC.-ANT CAMERON I'-. L1EC E.' _ _ � ___._.._.___DATE�"�� tt� Brittingr- by A & I, DRILLING COMPANY�� BOX 97, EAGLE RIVER, ALASKA 99577 a TELEPHONE 694-2588 OWNER OF LANDt-✓c,o,,J �� 4 U +mit S DEPTH OF WELL ADDRESS STATIC LEVEL OF WATER FT. :a LEGAL DESCRIPTION DRAW DOWN FT. DATE - Started C 176- EndedA4 GALS. PER HR ,S• PERMIT NUMBER KIND OF CASING�� KIND OF FORMATIO//N:,, ` From 0 Ft. to�Ft, J /9-'-) �� �`'� P �� � � From Ft. to Ft. From L. Ft. to -- ) 6- Ft. �f �� From Ft. to Ft. From <- Ft. to -) % Ft. Gl Jy' "- r �dU (• From Ft. to Ft. From_.S Ft. to lFt. From Ft. to Ft From 1 Ft. to_61_Ft. From - Ft. to Ft From , . ti Ft. to A) Ft. //kRv 2at 6C -: From Ft. to Ft. From_ l i Ft. to��� Ft. From Ft. to Ft. From but%' Ft. to J 3( Ft. From - Ft. to Ft. From /- G, Ft. to % Ft. 1_1?191,7`0,e1 Q ?"J'7 From Ft. to Ft. From Ft. to//-) Ft. %��r% R� C/� From Ft. to Ft. From Ft. to Ft. From - - Ft. to - Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From -- Ft. to Ft. From Ft. to Ft. From Ft. to - Ft. From Ft. to Ft. From Ft. to - Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME ' % > ,I- I- CD O 07 CD CD M M � � UA (1) x 0 ^` W 10 � d' N O N rn (N d' N n C 0 cu 0- x x W O O O I N O I O N 1 O l� O U LO O m Q ^L, W N> L.L m r (Q W J W Q W Lli = J_ W � MN W c � O N Q U) U U) W (1) 0 co J Un x WA in 0 0 cn m E O LA N O N LO LO 6 is D m cu U W U fQ c O I O A C: Lld 0 O •IQ` W 1 OI �.1• VVU) m •v (1,`1 O a) O C �-- O v c� U) O U a) N N L I- i C = aa)) _ O y O Y N _Q 0 cu^W^ O N ^Q i I+ Q -� +J O O N c Qaa)) U "Fua) > OL a M E i Q 0 a ,., C -0 ,o N 'E O tJ � V O �7 EC) L N0 E a)i ++ ^ _ � a) 0 U O L ^O, a) 0 4; c O O> � v E Un �J©Q tl p D -0 'a Q = O L L Q L U (nc .� cv O r- 0 m cc O rn (D ++ t CJ •L t v 0 ^` W 10 � d' N O N rn (N d' N n C 0 cu 0- x x W O O O I N O I O N 1 O l� O U LO O m Q ^L, W N> L.L m r (Q W J W Q W Lli = J_ W � MN W c � O N Q U) U U) W (1) 0 co J Un x WA in 0 0 cn m E O LA N O N LO LO 6 is D m cu U W U fQ c O I L 0 Q 'D '> > QU LL (D 'E c� a) a) 0 � z Q X O .U) Y> U LL70 a) C Q U O w CL Q Z U¢ O Y U) c LU O .o (6 2 U Q t— O U Q F— F- Q O A O= Q' O •IQ` W 1 _Q = �.1• VVU) m •v �n VI L a) O a) O C �-- O v c� U) O U a) N N L I- i C = aa)) _ O y O Y N _Q 0 cu^W^ O N ^Q i I+ Q -� +J O O N c Qaa)) U "Fua) > OL a M E i Q 0 a ,., C -0 ,o N 'E O a) O Q EC) L N0 E a)i ++ ^ _ � a) 0 r M ^ ii O L ^O, a) 0 4; c O O> � v cn N m � N �I,J m E Q O -0 'a Q = O .ii Un Q +' C to L U (nc .� cv O r- 0 m cc O rn (D ++ t CJ d L t v L 0 Q 'D '> > QU LL (D 'E c� a) a) 0 � z Q X O .U) Y> U LL70 a) C Q U O w CL Q Z U¢ O Y U) c LU O .o (6 2 U Q t— O U Q F— F- Q a) x 0 4- M I* Al T- C: m 0 LL 0 n 0 z C) UL U N -A V ll, CN CL EU) C: ca M U) 0 4- M I* Al T- Mr -I O LL it] a kn -9 r— Pr a) E, (D m (D CL U- 4- < 0 CO a) 0 cu C) U U) CN C: U) Lo (1)CL Z: (1) 0 LO _0 (1) CF) CD 0 U) >1 N U) 4i 76 C_. 0-) E El Ln < E U) CL❑E c 0 0 z 0 U Q) U) >1 _0 D Q a) > iz) C\j 0) U) C: 0 ry .c > U) C: — E W m > E 0 'n U) 0) mU) E El El (1) 0 Lij C: a) 70 C.) �p LL 0 U) > + CY) 0- C: U) > >, U) L- C/) CD -�e < o 0 El 0 w — W (1) 0) co < w '0 R El 0 0 > 0 CL 0,5co D 0 L 7- I ou (1) :2 El C: 0 cy) 0 C\l t w 0 ❑ U) &. co m LL Nw E N a. ME V5 a. 0 cn U) a 0 0 _0 0 2 M LU (D w (D E: 0- a) EM co tf C/Q ) >- CO Q z10 0 z 0 0- U) w U. U - A) I M a) w uj 0 _0 a) 0 0 0 U 0 a. CL 13. w a) CD M a) _0 F- F- U) < < > a; N Mui x LU m 0 Mr -I O LL it] a kn -9 r— Pr a) E, (D m (D CL U- 4- < 0 CO a) 0 cu 1.27 Forge Engineering 4/29/24 5/13/24 N/A N/A N/A Biocycle system Benjamin Schiller, P.E. (907) 522-7773 Inspection Report 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 Homeowner Info Initial Inspection: System Inspection Customer Name:Tank #: Install Date: Is System Lid Locked? Inlet plumbing in working order? Are all aerators functioning? Pump float operating? Date: Filter cleaned?Discharge line condition: Alarm float functioning?Any buildup of solids? Clarification return system operating? pH Reading: (pH of 6-8 is ideal) Dissolved Oxygen PPM (2-5 is ideal) Turbidity of discharge (in FTU) (Under 35 FTU is considered compliant.) Solids pillow normal? Any buildup of solids? Any buildup of solids? Lid hardware in working order?Is there any noticeable odor? Alarms Tested: Air High Water Does system have a septic tank ? Battery Tested:Yes No Yes Yes Yes Good Replaced Yes Yes Yes Yes Yes Yes Strong Mild None No Yes Yes Repaired Replaced Replaced Replaced Replaced No Adjusted Requires Pumping No No Yes Repaired N/A Primary Chamber Aeration Chamber Clarification Chamber Effluent testing result Discharge Chamber Yes Comments: Inspected By: N/A (Recommend pumping tank every 2 years) (Please make sure alarm is on "normal", not "mute") Address:Area: Has emailing or mailing of form been requested? (contact office to request...)Yes No MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this l p Day of 6L�A of 20 7J , by and between -2wvr-k1 , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment System . The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Biocycle located at (legal description) Mile High Block 1 Lot 1 2. Maintenanw, Repairs and Alterations. (Owner is required to read, understand and initial each section) :�'V-7 Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. a Da Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. �j Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by -the AWWTS vendor/installer and approved by the Municipality are the governing g*delines-for the constriction, maintenance and repair of the Owner's AWWTS. Owtter'agrees to maintain remote monitoring of the AWWTS as required by the A-VVWTS• approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 Cd Q I PW M w 0 M N cC P-4 0 N W W) D v MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 1,,j Day of L\�A-tA of 20ZtA , by and between 1t� �SS�ne-+mss herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) Mile High Block 1 Lot 1 2. Maintenance Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. 11� It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the,AWWTS vendor/installer and approved by the Municipality are the governing guidelines, for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the _AW WTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OI � N E" Cd C 15 RJ v� N cd C � 00 0 N 00 0 u Quarter Inspection Report 3705 Arctic Blvd #313 Anchorage AK 99503 Email: crbioak@gmail.com (907) 274-0314 Homeowner Info Initial Inspection: System Inspection Customer Name:Tank #: Install Date: Is System Lid Locked? Inlet plumbing in working order? Are all aerators functioning? Pump float operating? Date: Filter cleaned?Discharge line condition: Alarm float functioning?Any buildup of solids? Clarification return system operating? pH Reading: (pH of 6-8 is ideal) Dissolved Oxygen PPM (2-5 is ideal) Turbidity of discharge (in FTU) (Under 35 FTU is considered compliant.) Solids pillow normal? Any buildup of solids? Any buildup of solids? Lid hardware in working order?Is there any noticeable odor? Alarms Tested: Air High Water Does system have a septic tank ? Battery Tested:Yes No Yes Yes Yes Good Replaced Yes Yes Yes Yes Yes Yes Strong Mild None No Yes Yes Repaired Replaced Replaced Replaced Replaced No Adjusted Requires Pumping No No Yes Repaired N/A Primary Chamber Aeration Chamber Clarification Chamber Effluent testing result Discharge Chamber Yes Comments: Inspected By: N/A (Recommend pumping tank every 2 years) (Please make sure alarm is on "normal", not "mute") Address:Area: Has emailing or mailing of form been requested? (contact office to request...)Yes No Municipality of Anchorage On-Site Water and Wastewater Program' (907)343-7904 s ETY Certificate of On-Site Systems, Approval Parcel I.D. 050-201-02 Expiration Date: 1. GENERAL INFORMATION: Complete legal description Mile Hi: Block 1 Lot 1 Location (site address) 21827 Mile Hi *Eagle River, AK 99577 Current Property owner(s)Paul &Jessica Meyer' Day phone '919-770-6681 "Mailing address 21827 Mile Hi *Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL. Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community`Class Well ❑ Community Public Water System ❑ Public Sewer Waiver/Variance request for. Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6_6Z Waiver Fee $ Date of Payment t 2�t i g Date of Payment Receipt Number �'��b?r Receipt Number COSA#— Q 5 Cl X 133.3 Waiver 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE N System #1 Approved for :3bedrooms bedrooms oloTY OF,aA!�//// J�O _ bedrooms, with the followiti-tipullg "o-A'SETE ATE R AND m System #2 Approved for Disapproved Conditional approval for Z I11 / 11..... .... ......... ....... r e f l n\Garnes. CE -795.1 wa �c a r0fession o ���oo�oGG #AECC884 '�J�)))1)11111111. By: �'�— \ ii / Original Certificate Date: i -,u The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist in Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc COSA Checklist Legal Description: Mile Hi; Block 1, Lot 1 Parcel ID: 050-201-02 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/25/76 Total depth 142 ft Cased to 57 ft ® Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/15/19 Static water level at beginning of test 64.5 ft Comments B. TANK DATA Age of tank(s) 18 years Tank type/material '`°""p Measured operating fluid level in septic tank Unknown ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Biocycle Well production at time of test 5.0+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate \ ."� �p mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Ea/Arsenic less than MRL (ND) Collected by GEG, Ltd. Date of Sample 7/15/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Which system tested (date installed) 2001 Adequacy test date 7/16/19 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 2.75 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 527 gal ❑ N/A — pressurized field .*� 25 , New depth In ❑ Monitor tubes go to bottom of effective. If not, state 135 depth into effective Elapsed time min El Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to 1 Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced *"454 gallons If yes, enter date - Comments/Deficiencies: 'Assumed "Drainfield 100% full (7 inches of liquid) after 454 gallon pre-soak on 7/15/19 COSA Checklist yellow sheet N(I E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft ❑r Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' S✓ Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' 21 Yes if No ❑v Yes if No ft Manure/Animal Excreta Storage > 100' —❑✓ Community Sewer Main > 75' E] Yes if No ft Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' 0 Yes if No ft Community Wells > 200'✓0 Yes if No Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No Surface Water > 100'❑ Yes if No ft F. ENGINEER'S COMMENTS *Immediately next to shed G. ENGINEER'S CERTIFICATION o� OF I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. : , , . ...i . .............. Q -,J y A. Garn ss,, QO 41 ' CE— 5 �Q sf •. _ _• �\cOG COSA Checklist yellow sheet 444a Pr �� - o0 ofessto #AECC884 ft ft ft ft DocuSign Envelope ID; 2CBC98F4-7C65-47DB-87AF-5405A156DDC7 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 15 Day of j of 20 11 , by and between Olivia R. Britton , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as BioCycle located at (legal description) Mile Hi Blk 1 Lt 1 / 21827 Mile Hi Avenue, Eagle River AK 99577 2. Maintenance, Repairs and AIterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to g pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 Docu,Sign Envelope ID: 2CBC98F4-7C65-47DB-87AF-5405A155DDC7 OWNER: By: (signature) Date: —INWkc,� �(print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoin ins rument was acknowledged before me this day of 20-1, by � d.— "&V fTARY UB ORA SKA c mmission expires: ®A ;N (i811G MUNICIPALITY By: -- (signature) l (print name) Date: Title: (rev. 05/18/2018) Page 3 of 3 3705 Arctic Blvd #313 LuJ�OO YCLET"Alaska Anchorage AK 99503 '�°�nncetl �V p9tOw Syslom°s nonf Email: crbioak@gmail.com (907) 274-0314 1st Quarter Inspection Report 2019 Homeowner Info Customer Name: Paul and Jessica Meyer Tank#: 105 Install Date: June 2001 Address: 21827 Mile High Area. Eagle River Initial Inspection: Alarms Tested: Air 0 High Water A Battery Tested: Yes ❑ No ❑ N/A (Please make sure alarm is on "normal", not "mute") Does system have a septic tank ? No A Yes ❑ (Recommend pumping tank every 2 years) Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor? Yes k6 Repaired ❑ Yes Repaired ❑ Strong ❑ Mild ❑ None [� System Inspection Inlet plumbing in working order? Solids pillow normal? Yes 0 Replaced ❑ Yes A Requires Pumping ❑ Are all aerators functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes ❑ No 0 Clarification return system operating? Any buildup of solids? Yes 0 Adjusted ❑ Yes ❑ No [� <'EfFluerit testing result pH Reading: Dissolved Oxygen PPM Turbidity of discharge (in FTU) (pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.) 8.0 4.0 4.76 Pump float operating? Alarm float functioning? Any buildup of solids? Yes 0 Replaced ❑ Yes R1 Replaced ❑ Yes ❑ No 0 Filter cleaned? Discharge line condition: Yes [✓ N/A ❑ Good © Replaced ❑ Comments: Inspected By: Chris Has emailing or mailing of form been requested? Yes ❑ No Date: 03/18/2019 (contact office to request...) ❑ Grt b • '� Municipality of Anchorage On -Site Water and Wastewater Program" - (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-201-02 Expiration Date: 62' y- 1. GENERAL INFORMATION Complete legal description MILE HI BLOCK 1, LOT 1 Location (site address) 21827 MILE HI AVE. EAGLE RIVER, AK 99577 Current Property owner(s) WENDY & GRAHAM VAUGHN Day phone Mailing address Real Estate Agent 2. TYPE OF DWELLING: _21827 MILE HI AVE. EAGLE RIVER AK 99577 ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: S TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _ Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: COSA to be released to the engineer, unless ofer&e requested by the engineer. COSA Fee $ Date of Payment Receipt Number COSA# 13ID(ONO A Waiver Fee $ Date of Payment Receipt Number Waiver # 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING INC Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS_ Date 09/02/2016 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen + encroachments, deficiencies or discrepancies exist. A -��'� OF ALA \,TH 6. DSD SIGNATURE `9 KENNETH M. D TE System #1 Approved for bedrooms. f1 g „g $� j System #2 Approved for bedrooms. ,;,ss DizP`� Disapproved. Conditional approval for bedrooms, with the following stipulations: BYw Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA bim sheet 10AD.12AM X Nitrate Advisory, ,,. Arsenic AdVi'sdrq. Other If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: MILE HI BLOCK 1, LOT 1 Parcel ID: 050201.02 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # _ Date completed 6.25.1976 Sanitary seal (YIN) Y Total depth 142 ft. Cased to 57 ft. FROM WELL LOG Date of test 612511976 Static water level 52 ft. Well production 3 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 1.06 mg/L Arsenic: ND ug/L Date of sample: 8123/2016 B. SEPTIC/HOLDING TANK DATA Tank Type/Material BIO CYCLE Tank size 1600 gal.. Number of Compartments 4 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping Pumper LARRY BETTS/ A+ C. ABSORPTION FIELD'DATA Date installed 6/5/2001 Soil rating (g.p.d./ft2 or ft2/bdrm) 2 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 8123116 40 ft. 6.25 g.p.m. Collected by: ARCTERRA Date installed 61812Q01 Cleanouts (Y/N) Y High water alarm (Y/N) Y System type BED Length 15 ft. Width15 ft. Gravel below pipe 0.5 ft. Total depth 3 ft. (Measured 8123/16) Eff. absorption area 225 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/2312016 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 500 gal. New depth 6 in. Elapsed Time: 45 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 6/8/2001 Size in gallons 1600 Manhole/Access (Y/N) Y "Pump on" levet at 25 in. "Pump off" level at 44:5 in. High water alarm level at 22.5 in. Datum TOP OF TANK Cycles tested 2 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tankAift station on lot 1001+ Absorption field on lot 1004 Publicsewermain 754 Sewer /septic service line 251+ Animal containment areas 501+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 54 On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 1004 Holding tank 100'+ Manure/animal excrete storage areas 1004 Absorption field 5'+ Water main 104 Water service line 10'+ Surface water 1004 Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 104 Water Service line 104 Surface water. 1004 Driveway, parking/vehicle storage 104 Curtain drain 50'+fNONEKWM Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 9/212016 COSA canary sheet 2-6-15.doc OF A1,4 ,r fP KENWNt / l � ; BiioCyCle Alaska Aerated wastew(tter tre(Itrrlelrt st:stehls � (,Q Biocycle History Date 9.'T Tank # DS Year system was installed QQQ J Address: ��"% �� �� I j�` aj1 AUC Cloje - V l_ � Engineer of record "7"dbb-cr) v � r I Dr)�Installer-BDL LtDn PE Has electrical system been upgraded? Approximate age of air blower nt 1-S l V tclr (air blowers typically last a minimum of five years) Approximate age of discharge pump—15 LCn S —Ori i ha (dishcharge pumps typically last a minimum of ten years) U mp Date system was last pumped (Q . • �� J Comments: Biocycle Alaska 3705 Arctic Blvd #313 Anchorage, AK 99503 (907)274-0314 erbioak@gmail.com 0 Ip N90°00' MILE -HI AVENUE LOT 3 ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: MILE -HI SUBDIVISION LOT 1 BLOCK 1 GRID NW0058 PLAT 66-80 SURVEY CERTIFICATION: I, John L. Schuller, have conducted a •�'� OF'' A �\ physical survey of this property as shown on this drawing and i 'S'j-..-•-• .L that the improvements situated thereon are within the property lines and no enchroachments exist other that noted. / `�.• , TH 4 `* .. EXCLUSION NOTES: It is the owners responsibility to determine the *.... ............. existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Under no y..... HN�SCHULLER, o circumstance should any information on this drawing be used for f ,c. .� construction of fences, structures, improvements, or for �INr LS -10408 �o� establishing boundary lines. ', o A., ca5iAV WORK ORDER NUMBER: DATE: SIM -MAIC `� SEPT 15, 2016 1 0 f"=30' \� essiona_� 16-u50 KED DRAWN BY: CHECBY GRID NUMBEOKR: BOAGE: \`"�+ JLS NW0058 160165 LOT 6 BLOCK 2 O = FIND 1/2" REBAR yo pp,D LND���' - �t-1 eS 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax Municipality of Anchorage —• Development Services Department Building Safety Division On -Site Water and Wastewater Program ` ~ 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchora ge.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O F7 D — ot.o I — D 2 HAA #Q h/ t/ Expiration Date: i — o I GENERAL INFORMATION Complete legal description L -OT k 'B 1 E'I- i Location (site address or directions) �,l uI c — I41 A,-Q_ n Current Property owner(s) Oct K C i {Se- Day phone 5&L 6 L1 % y Mailing address Lending agency Mailing address Real Estate Agent Mailing Address F.b. Bog 773&1p Day phone Wrr<.r Ajitj �t)HH� Dayphone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site P Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Deve!opment Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal endlor water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Heath Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or S wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF. INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm j ebb-elir v A_lactai� Address rho 3 W/ 5 LCf H;7_0 3 Engineer's Printed Name I oh%-eH S' v rl tee M914R `►E -W NA t/ Approved for 2 bedrooms. Disapproved. Phone d-19 -3cr/ b Date G —! Y—O f ENG NEERrS °'.•• �,r } d, .�.:STAIviP .d� iE iwn �•... u0.°°�,�v b Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 11 W, Oricinai Certificate Date: (Rev. 12C0) Municipality of Anchorage • Development Services Department Building Safety Division On-Sfte Water 3 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.cl.anchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L o 4- I 5V, 1 t4 %1-4- -14 + Parcel ID: 0 50 - U I - O s A. WELL DATA Well type K Date completed �17(I Total depthE,I ft. If A, B. or C provide PWSID # � Well Log (YIN) Y Sanitary seal (YM) Wires properly protected (YM) _ — Cased to &_Zft. Casing height (above ground) n. FROM WELL LOG Date of test b 44-11 io Static water level rJ I- ft. Well production 3 g.p.m. WATER SAMPLE RESULTS: AT INSPECTION H3 ft. % g.p.m. Cdlform At_colonies/100 ml. Nitrate 1s E mg./I. Other bacteria colonies/100 ml. Date of sample: bl ►'bio I Collected by: B. SEPTICIHOLDING TANK DATA / Tank Type/Material L13' r o N c I e- Date installed b1 B L 0 f Tank size 40V gel. Number of Compartments—q- Cieanouts (YM) Y Foundation cleanout (Y/N) -)L Depression over tank (YM) -bl- High water alarm (Y/N) Date of pumping NA Pumper A-1. C. ABSORPTION FIELD DATA Z Date installed d/5%21 Soil rating (g.p.d./fe or ft=/bdrm) ei� System type _ . to Length /5 ft. Width / ft. Gravel below pipe 4, ft. Total depth ft. Eft. absorption area 195 -ft' Monitoring tube _ Depression over field t_ Date of adequacy test f4/A Results (Pass/Fail) V-10, For .3—bedrooms Fluid depth In absorption field before test ✓n. Water addedWgal. New depth in. Elapsed Time: ✓ min. Final fluid depth ✓ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YM 8 type) V If yes, give date V